scholarly journals Comparison of Real-Life Systems of Care for ST-Segment Elevation Myocardial Infarction

Global Heart ◽  
2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Surya Dharma
Keyword(s):  
Myocardial Infarction ◽  
Systems Of Care ◽  
Real Life ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

scholarly journals Taking the Reins on Systems of Care for ST-Segment–Elevation Myocardial Infarction Patients

2018 ◽  
Vol 11 (5) ◽  
Author(s):  
Jacqueline L. Green ◽  
Alice K. Jacobs ◽  
DaJuanicia Holmes ◽  
Karen Chiswell ◽  
Rosalia Blanco ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systems Of Care ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Treatment of ST-segment elevation acute coronary syndromes

ESC CardioMed ◽  
2018 ◽  
pp. 1255-1276
Author(s):  
Borja Ibanez ◽  
Sigrun Halvorsen
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Clinical Trials ◽  
Acute Coronary Syndromes ◽  
Real Life ◽  
Compelling Evidence ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Coronary Syndromes

Over the last 50 years, the treatment of acute ST-segment elevation myocardial infarction (STEMI) has been considerably improved. The widespread implementation of reperfusion (initially pharmacological and later mechanical) resulted in a magnificent reduction in the rates of in-hospital mortality from about 25% in the 1970s to 5% in the late 2010s. Mortality in real life, however, is higher than these figures shown in clinical trials. There is compelling evidence showing the association between duration of ischaemia and mortality. This is the basis for the timely reperfusion in STEMI. All actions should be made to reduce all components of the ischaemic time. Despite these advances, STEMI survivors are still at high risk for developing repetitive events, including reinfarctions, heart failure, and sudden death. Evolving therapies beyond timely reperfusion are contributing to further reduce the morbidity associated with STEMI.

scholarly journals REAL-LIFE ASSESSMENT OF CANGRELOR P2Y12-INHIBITION IN PATIENTS WITH ST-SEGMENT-ELEVATION MYOCARDIAL INFARCTION

2016 ◽  
Vol 67 (13) ◽  
pp. 542 ◽  
Author(s):  
Moman Aladdin Mohammad ◽  
Pontus Andell ◽  
Matthias Götberg ◽  
Fredrik Scherstén ◽  
Sasha Koul ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Real Life ◽  
Life Assessment ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

scholarly journals Association of Cardiac Care Regionalization With Access, Treatment, and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 14 (3) ◽  
Author(s):  
Yu-Chu Shen ◽  
Harlan Krumholz ◽  
Renee Y. Hsia
Keyword(s):  
Myocardial Infarction ◽  
Systems Of Care ◽  
Coronary Intervention ◽  
Relative Increase ◽  
Base Rate ◽  
Administrative Database ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Percentage Points ◽  
St Segment

Background: Regionalization of ST-segment elevation myocardial infarction (STEMI) systems of care has been championed over the past decade. Although timely access to percutaneous coronary intervention (PCI) has been shown to improve outcomes, no studies have determined how regionalization has affected the care and outcomes of patients. We sought to determine if STEMI regionalization is associated with changes in access, treatment, and outcomes. Methods: Using a difference-in-differences approach, we analyzed a statewide, administrative database of 139 494 patients with STEMI in California from 2006 to 2015 using regionalization data based on a survey of all local Emergency Medical Services agencies in the state. Results: For patients with STEMI, the base rate of admission to a hospital with PCI capability was 72.7%, and regionalization was associated with an increase of 5.34 percentage points (95% CI, 1.58–9.10), representing a 7.1% increase. Regionalization was also associated with a statistically significant increase of 3.54 (95% CI, 0.61–6.48) percentage points in the probability of same-day PCI, representing an increase of 7.1% from the 49.7% base rate and a 4.6% relative increase (2.97 percentage points [95% CI, 0.1–5.85]) in the probability of receiving PCI at any time during the hospitalization. There was a 1.84 percentage point decrease (95% CI, −3.31 to −0.37) in the probability of receiving fibrinolytics. For 7-day mortality, regionalization was associated with a 0.53 (95% CI, −1 to −0.06) percentage point greater reduction (representing 5.8% off the base rate of 9.1%) and a 1.75 percentage point decrease in the likelihood of all-cause 30-day readmission (95% CI, −3.39 to −0.11; representing 6.4% off the base rate of 27.4%). No differences were found in longer-term mortality. Conclusions: Among patients with STEMI in California from 2006 to 2015, STEMI regionalization was associated with increased access to a PCI-capable hospital, greater use of PCI, lower 7-day mortality, and lower 30-day readmissions.

scholarly journals Systems of Care for ST-Segment–Elevation Myocardial Infarction: A Report From the American Heart Association’s Mission: Lifeline

2012 ◽  
Vol 5 (4) ◽  
pp. 423-428 ◽  
Author(s):  
James G. Jollis ◽  
Christopher B. Granger ◽  
Timothy D. Henry ◽  
Elliott M. Antman ◽  
Peter B. Berger ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
American Heart ◽  
Systems Of Care ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

scholarly journals Systems of Care for ST-Segment–Elevation Myocardial Infarction: A Policy Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Alice K. Jacobs ◽  
Murtuza J. Ali ◽  
Patricia J. Best ◽  
Mark C. Bieniarz ◽  
Vincent J. Bufalino ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Community Education ◽  
Systems Of Care ◽  
Heart Association ◽  
System Of Care ◽  
Policy Statement ◽  
Optimal Care ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

The introduction of Mission: Lifeline significantly increased timely access to percutaneous coronary intervention for patients with ST-segment–elevation myocardial infarction (STEMI). In the years since, morbidity and mortality rates have declined, and research has led to significant developments that have broadened our concept of the STEMI system of care. However, significant barriers and opportunities remain. From community education to 9-1-1 activation and emergency medical services triage and from emergency department and interfacility transfer protocols to postacute care, each critical juncture presents unique challenges for the optimal care of patients with STEMI. This policy statement sets forth recommendations for how the ideal STEMI system of care should be designed and implemented to ensure that patients with STEMI receive the best evidence-based care at each stage in their illness.

Treatment of ST-segment elevation acute coronary syndromes

ESC CardioMed ◽  
2018 ◽  
pp. 1255-1276
Author(s):  
Borja Ibanez ◽  
Sigrun Halvorsen
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Clinical Trials ◽  
Acute Coronary Syndromes ◽  
Real Life ◽  
Compelling Evidence ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Coronary Syndromes

Over the last 50 years, the treatment of acute ST-segment elevation myocardial infarction (STEMI) has been considerably improved. The widespread implementation of reperfusion (initially pharmacological and later mechanical) resulted in a magnificent reduction in the rates of in-hospital mortality from about 25% in the 1970s to 5% in the late 2010s. Mortality in real life, however, is higher than these figures shown in clinical trials. There is compelling evidence showing the association between duration of ischaemia and mortality. This is the basis for the timely reperfusion in STEMI. All actions should be made to reduce all components of the ischaemic time. Despite these advances, STEMI survivors are still at high risk for developing repetitive events, including reinfarctions, heart failure, and sudden death. Evolving therapies beyond timely reperfusion are contributing to further reduce the morbidity associated with STEMI.

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